Catathrenia
A sleep disorder characterized by groaning or moaning sounds during sleep, particularly during exhalation.
What is Catathrenia?
Catathrenia, also known as nocturnal groaning or sleep-related groaning, is an uncommon parasomnia characterized by expiratory groaning or moaning sounds during sleep. The groaning typically occurs in clusters, mainly during REM sleep, and can last from several seconds to a minute per episode. The sounds are produced during prolonged, deep exhalation. While harmless to the affected person, catathrenia can be very disturbing to bed partners and roommates. The exact cause is unknown, but it is classified as a sleep-related breathing disorder rather than a classic parasomnia.
Prevalence
Catathrenia is relatively rare, though the exact prevalence is unknown. It appears to be more common in males and typically begins in adolescence or young adulthood. Many cases go unreported or are mistaken for snoring. Awareness of the condition has increased in recent years, leading to more diagnoses.
Causes
The exact cause of catathrenia is unknown. It appears to involve partial closure of the upper airway during exhalation in sleep, creating the characteristic groaning sound. Unlike snoring (which occurs during inhalation), catathrenia occurs during long exhalations. Possible contributing factors include upper airway anatomy, changes in breathing patterns during REM sleep, and neural control of breathing. It is not associated with sleep apnea or other significant respiratory problems.
Symptoms
Groaning sounds during sleep
Monotonous groaning, moaning, or humming sounds produced during exhalation. The sounds can be quite loud and sustained.
Occurrence during exhalation
Unlike snoring which occurs during inhalation, catathrenia sounds occur during prolonged exhalation lasting up to 30-50 seconds.
Cluster pattern
Episodes tend to occur in clusters throughout the night, particularly during REM sleep in the second half of the night.
No awareness by the sleeper
The person making the sounds is unaware and has no memory of groaning. Sleep quality is typically unaffected.
Bed partner disturbance
The primary complaint usually comes from bed partners or roommates who are awakened by the sounds.
Normal breathing pattern otherwise
No apneas, oxygen desaturation, or other breathing abnormalities are present.
Diagnosis
Self-Assessment Questions
If you answer yes to any of these questions, consider consulting a sleep specialist:
- 1Has a bed partner or roommate told you that you groan or moan during sleep?
- 2Are the sounds described as occurring during breathing out, often sustained?
- 3Do you have no memory of making these sounds?
- 4Is your own sleep quality unaffected?
- 5Do episodes occur throughout the night, perhaps worse in the second half?
- 6Have you been told the sounds are different from snoring?
Diagnosis is based on bed partner reports of characteristic groaning sounds during exhalation. Polysomnography can confirm the diagnosis by capturing episodes and documenting that they occur during REM sleep with prolonged exhalation.
Bed Partner History
Description of the groaning sounds, including timing (during breathing out), pattern, and loudness.
Audio/Video Recording
Recording sounds at night can capture the characteristic groaning pattern and distinguish it from snoring.
Polysomnography
Sleep study documents prolonged exhalation with groaning sounds, typically during REM sleep, without apneas or desaturation.
Treatment
Catathrenia is challenging to treat, and there is no consistently effective therapy. It does not harm the sleeper, so treatment focuses on reducing disturbance to bed partners.
CPAP Therapy
Some case reports suggest CPAP may reduce catathrenia, possibly by keeping the airway more stable during exhalation.
Oral Appliances
Mandibular advancement devices, similar to those used for snoring, may help some patients.
Bed Partner Accommodations
Earplugs, white noise machines, or separate sleeping arrangements may be necessary for severely affected bed partners.
Positional Therapy
Some patients have less catathrenia in certain sleep positions; experimentation may help.
Sleep Surgery
Upper airway surgery has been tried in a few cases with variable results.
Lifestyle Adjustments
- •Try different sleep positions to see if one reduces groaning
- •Maintain regular sleep schedules
- •Consider white noise for bed partner
- •Avoid alcohol before bed
- •Keep the bedroom at a comfortable temperature
- •Communicate openly with bed partner about the condition
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